# Expanding Access to Buprenorphine Treatment among Homeless Persons with Opioid Use Disorder

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $243,292

## Abstract

ABSTRACT
Opioid overdose is a major cause of death among people experiencing homelessness. Although
buprenorphine treatment is effective for opioid use disorder (OUD), homeless persons experience multiple
barriers to accessing this life-saving medication. Recently, the FDA approved a once-monthly injectable
extended-release buprenorphine formulation for treatment of OUD, which may offer an alternative to sublingual
buprenorphine for populations challenged by adherence, such as homeless persons. Long-acting formulations
of buprenorphine treatment hold promise for improving adherence, retention, and clinical outcomes. However,
little information exists about how amenable out-of-treatment homeless persons with OUD may be to an
injectable buprenorphine formulation. Furthermore, although buprenorphine treatment can occur in a variety of
settings, limited research has measured readiness of system models of care for the treatment of OUD among
homeless persons. This project aims to assess individual, provider and system-level barriers and facilitators to
accessing buprenorphine treatment among homeless people with OUD. Guided by the Consolidated
Framework for Implementation Research, we will use an exploratory sequential mixed method design to
identity potential individual, provider, and system-level barriers to implementation of buprenorphine treatment
in two service settings: homeless shelters and syringe access programs. The specific aims of the project are:
(1) assess organizational capacity and organizational readiness for the expansion of buprenorphine treatment
in homeless shelters and syringe access programs; and (2) assess willingness of homeless people with OUD
to receive buprenorphine treatment, preferences for different buprenorphine treatment formulations (sublingual
vs. injection), and identify factors associated with preferences for buprenorphine treatment formulations. To
achieve Aim 1, we will conduct in-depth interviews, focus groups, and surveys with health care providers,
program staff, and program directors working at homeless shelters and syringe access programs. In Aim 2, we
will recruit 200 homeless persons from homeless shelters, syringe access programs, and homeless
encampments; and then administer structured surveys to identify preferences for buprenorphine treatment
formulations, and identify predictors of preferences for different buprenorphine treatment formulations.
Researchers can use the results of this study to inform the planning of buprenorphine treatment for out-of-
treatment homeless persons with OUD, and we will use these results to conduct a subsequent feasibility and
acceptability trial of sublingual buprenorphine vs. extended release buprenorphine to treat OUD in homeless
persons.

## Key facts

- **NIH application ID:** 9877468
- **Project number:** 1R21DA050038-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Carmen L Masson
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $243,292
- **Award type:** 1
- **Project period:** 2020-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9877468

## Citation

> US National Institutes of Health, RePORTER application 9877468, Expanding Access to Buprenorphine Treatment among Homeless Persons with Opioid Use Disorder (1R21DA050038-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9877468. Licensed CC0.

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